Ditch bad kidneys - Docs say transplants cheaper than dialysis

Prominent nephrologists are advocating the use of kidney transplantation as a measure to reduce the increasing number of kidney-disease sufferers awaiting dialysis.

Transplantation, they said, would also lower treatment costs, improve patient care and reduce the numbers who die from the disease.

"It is far cheaper to transplant patients than to keep them on dialysis (as) some are on dialysis for up to 35 years ... ," said Professor Everard N. Barton, director of the Caribbean Institute of Nephrology based at the University of the West Indies, Mona.

Barton explained that transplantation cost becomes cheaper after two and a half years when compared with dialysis and it would significantly reduce the strain on the already overburdened public health system, cut the waiting list for dialysis and, thereby, reduce the likelihood of patients dying.

"There is a long waiting list of patients. You really should have dialysis three times a week, which happens overseas. Here in Jamaica, because of manpower, we dialyse patients twice a week unless patients have a condition that requires us to do them three times a week," Barton revealed while addressing a Gleaner Editors' Forum at the newspaper's North Street, central Kingston, offices..

In fact, consultant internist and nephrologist Dr Adedamola Soyibo told those in attendance at the forum that "there is a four- to five-year waiting period".

Figures from the Caribbean Institute of Nephrology show there are approximately 1,835 persons suffering from kidney disease in Jamaica as at 2012. About 598 of that number require dialysis. But the number of kidney-disease sufferers could be higher, as Barton said data collection, especially in rural areas, was not reliable and so there could be undetected cases. Males seem to account for the larger number of sufferers.

It costs an average $1.2 million annually to care for a patient on haemodialysis based on 2005 calculations.

But numbers are growing and there may be many others who don't know about their condition. The elite group of medical specialists - 11 in the island - who treat kidney disease, are concerned that the country's health-care system might not be able to cope.

"The unit (at the UHWI) cannot provide for all the patients who really need to have this treatment," declared Sister Barbara Ritchie-Sinclair, the former director of the nephrology programme at the hospital. "There are some patients who really need dialysis three times per week and we try our best to facilitate them."

Said Barton: "But once patients are coming once a week, they don't do very well and then some come in once fortnightly or monthly and somewhere down the line, you don't see them again and you know (they have died)."

However, Soyibo argued that kidney transplantation, outside of a public-awareness programme about kidney health, could be an effective measure in alleviating the situation.

"We need to look at new ways (such as) kidney transplant," argued Soyibo. He suggested that the procurement of organs such as kidneys would not be difficult in Jamaica as they could be obtained through several ways, including from persons involved in motor-vehicle accidents.

"One (method) is the cadaver or brain-dead person, who is involved in a tragic accident and the other is from live donation (which) is not detrimental to the donor," Soyibo suggested.

Along with appropriate legislation, Soyibo said the public could be encouraged through sensitisation to donate their organs. If persons wear wristbands engraved, 'I am an organ donor', it will facilitate easy procurement of an organ in the event of a motor-vehicle crash or gunshot wound.

Barton stressed, however, that organ donation would have to be a voluntary and free process for it to function effectively.